A retrospective comparison of purging type disorders: Eating disorder not otherwise specified and bulimia nervosa

Abstract

Objective: In light of recent research indicating the clinical significance of eating disorder not otherwise specifiedpurging only (EDNOS-P), differences between women with lifetime bulimia nervosa purging subtype (BN-P) and EDNOS-P were examined.Method: Three groups of women were examined, a control group (n ¼ 684) and two groups with lifetime eating disorders: BN-P (n ¼ 22), and EDNOS-P (n ¼ 53).Results: Women with lifetime BN-P were significantly more likely to use vomiting than women with EDNOS-P but the latter group relied more on laxative abuse. Compared with controls, women with both eating disorders had higher weight and shape concern, dietary restraint, lifetime major depression, and suicidality. The BN-P group had significantly higher eating concern, dietary restraint, and suicidality than the EDNOS-P group. Conclusion:In accordance with previous research examining women with current eating disorders, EDNOS-P is indicated to be clinically significant. On the whole, the pattern of results indicated that EDNOS-P lies somewhere between BN-P and healthy controls in its clinical significance. V V C 2006 by Wiley Periodicals, Inc.

Eating disorder not otherwise specified: The view from a tertiary care treatment center

“…This research replicates a growing body of work, 4,5,7,8,14 which has shown that the group of patients who purge in the absence of objective binge episodes closely resembles those with BN P. The EDNOS purging only patients reported as much psychological disturbance on the EDI and Rosenberg self-esteem inventory as did those with BN P. Although the purging only group reported higher levels of depression than the BN P, both groups had very high scores and at these elevated levels of depression the difference in depression scores is likely not clinically noticeable. As well, previous research 8 suggests that differences between these groups on depression may not be stable.…”

“…2 A number of recent articles have focused on identifying subgroups of individuals within the broader EDNOS category. [3][4][5][6][7][8] In general, the small literature suggests that there may be justification to relax the current diagnostic boundaries between full syndrome BN and subsyndromal BN. 3,6,9 In addition, there appears to be a clinically significant subgroup of EDNOS patients with a purging only form of eating disorder-EDNOS P, 4,7,8 who both resemble and exhibit differences from patients with BN purging subtype (BN P).…”

Purging disorder: Subthreshold variant or full-threshold eating disorder?

“…c This group was included in analyses presented by Wade et al 16 and Wade. 17 associated with greater impulsiveness compared with PD. In a second study, Keel et al 8 replicated similarities in body image disturbance, dietary restraint, and overall eating disorder severity using structured clinical interview and self-report measures.…”

“…Studies that examined purging solely in the context of AN or BN were not reviewed in detail. A total of 14 articles were identified, [5][6][7][8][9][10][11][12][13][14][15][16][17][18] reflecting 10 separate samples of PD. A challenge in reviewing the literature of a condition which has not been formally named or defined is heterogeneity of names and definitions used for the syndrome.…”

“…However, current eating concern and dietary restraint and lifetime suicidality were lower in women with lifetime diagnoses of PD versus BN. 17 Finally, recent studies have found that PD and BN do not differ significantly in chronicity. 8,15 However, sample sizes and duration of follow-up were limited in the one-prospective study, 8 and the other study utilized a retrospective design to assess illness course.…”